Does employment alter the course and outcome of schizophrenia and other severe mental illnesses? A systematic review of longitudinal research

Luciano, Alison; Bond, Gary R.; Drake, Robert E.

doi:10.1016/j.schres.2014.09.010

Cited by 98 publications

(66 citation statements)

References 77 publications

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“…These results seem to partly contradict observational studies that have provided evidence that entering paid employment can improve health9 and decrease psychiatric treatment 13. Mueser et al 37 as well as Bond et al 38 showed in their RCTs that after 18 months follow-up participants with severe mental illness who obtained competitive employment tended to have less psychiatric symptoms, better overall functioning and higher self-esteem.…”

Section: Discussionmentioning

confidence: 92%

“…Another systematic review of 33 prospective studies showed that entering paid employment reduced the risk of depression (OR 0.52; 95% CI 0.33 to 0.83) and improved general mental health (OR 3.8 and effect size 0.66) 12. A recent systematic review of Luciano et al 13 showed that entering paid employment was associated with decreased psychiatric treatment and increased self-esteem. These results from observational studies are reflected in the powerful message of the so-called Black report on the health of Britain's working-age population: ‘Work, matched to one's knowledge and skills and undertaken in a safe, healthy environment, can reverse the harmful effects of prolonged sickness or long term unemployment, and promote health, well-being and prosperity’ 14…”

Section: Introductionmentioning

confidence: 99%

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Work as treatment? The effectiveness of re-employment programmes for unemployed persons with severe mental health problems on health and quality of life: a systematic review and meta-analysis

et al. 2016

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Given the importance of unemployment in health inequalities, re-employment of unemployed persons into paid employment may be a powerful intervention to increase population health. It is suggested that integrated programmes of vocational reintegration with health promotion may improve the likelihood of entering paid employment of long-term unemployed persons with severe mental health problems. However, the current evidence regarding whether entering paid employment of this population will contribute to a reduction in health problems remains unambiguous. This systematic review and meta-analysis aimed to assess the effects of re-employment programmes with regard to health and quality of life. Three electronic databases were searched (up to March 2015). Two reviewers independently selected articles and assessed the risk of bias on prespecified criteria. Measures of effects were pooled and random effect meta-analysis of randomised controlled trials was conducted, where possible. Sixteen studies were included. Nine studies described functioning as an outcome measure. Five studies with six comparisons provided enough information to calculate a pooled effect size of -0.01 (95% CI -0.13 to 0.11). Fifteen studies presented mental health as an outcome measure of which six with comparable psychiatric symptoms resulted in a pooled effect size of 0.20 (95% CI -0.23 to 0.62). Thirteen studies described quality of life as an outcome measure. Seven of these studies, describing eight comparisons, provided enough information to calculate a pooled effect size of 0.28 (95% CI 0.04 to 0.52). Re-employment programmes have a modest positive effect on the quality of life. No evidence was found for any effect of these re-employment programmes on functioning and mental health.

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Work as treatment? The effectiveness of re-employment programmes for unemployed persons with severe mental health problems on health and quality of life: a systematic review and meta-analysis

et al. 2016

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“…Vocational dysfunction is a substantial problem in persons with mental illness, with unemployment rates of up to 80% (cite SAMHSA 2012), leading to negative, quality of life, clinical, and psychosocial outcomes (Kukla et al, 2012;Luciano et al, 2014). In addition, poor employment outcomes result in serious financial issues, including low income (Zivin et al, 2011) and difficulties meeting basic life needs, such as food and shelter (Elbogen et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Subjective Experiences of the Benefits and Key Elements of a Cognitive Behavioral Intervention Focused on Community Work Outcomes in Persons With Mental Illness

et al. 2017

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New research suggests that group-based cognitive behavioral therapy (CBT) may help improve employment outcomes in persons with mental illness, yet the effects and potential key elements facilitating change in such interventions are unclear. Utilizing a mixed methods approach, this study examined the perspectives of persons with mental illness after participating in a pilot study of the "CBT for Work Success" intervention. Findings demonstrate that participants valued the intervention and perceived that it assisted them in achieving work goals. Therapeutic effects included improved self-efficacy, work motivation, enhanced sense of self as workers, and increased beliefs that work success is attainable. CBTw elements perceived to be important in facilitating work goals included cognitive restructuring, behavioral coping strategies, problem solving work barriers, meaningful reflection on oneself as a worker, and important factors associated with the group process. The authors discuss the implications of these findings and future research directions.

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“…Another systematic review of 33 observational longitudinal studies showed that entering paid employment reduced the risk of depression and improved general mental health (13). In addition, a recent systematic review of Luciano (14) showed that entering paid employment was associated with decreased psychiatric treatment and increased self-esteem among persons with schizophrenia or other severe mental illnesses. However, in these observational studies entering paid employment is not considered as a randomly occurring event.…”

mentioning

confidence: 99%

The benefits of paid employment among persons with common mental health problems: evidence for the selection and causation mechanism

Schuring¹,

Robroek²,

Burdorf³

2017

Scand J Work Environ Health

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There is a need to develop alternative evaluation designs to evaluate the effect of entering paid employment on health in observational studies. A hybrid model, combining fixed effects and random effects, enables the disentanglement of the selection and causation processes in paid employment. This study shows that employment has a positive influence on mental-and physical health, especially among high educated persons.

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Does employment alter the course and outcome of schizophrenia and other severe mental illnesses? A systematic review of longitudinal research

Cited by 98 publications

References 77 publications

Work as treatment? The effectiveness of re-employment programmes for unemployed persons with severe mental health problems on health and quality of life: a systematic review and meta-analysis

Work as treatment? The effectiveness of re-employment programmes for unemployed persons with severe mental health problems on health and quality of life: a systematic review and meta-analysis

Subjective Experiences of the Benefits and Key Elements of a Cognitive Behavioral Intervention Focused on Community Work Outcomes in Persons With Mental Illness

The benefits of paid employment among persons with common mental health problems: evidence for the selection and causation mechanism

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